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Advanced GeoEnvironmental, Inc. www.advt=_eoenv.com CHAIN OF CUSTODY RECORD <br /> 5Q 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 Date: L11►G 12,n l W Page___L Off_( <br /> F—I 381 Thor Place,Brea,California 92821 •Phone(714)529-0200•Fax(714)529-0203 t <br /> �` ��: '• ❑2318 Fourth Street,Santa Rosa,California 95404 •Phone(707)570-1418 •Fax(707)570-1461 f Analysis Required <br /> ❑ 395 Del Monte Center,#111,Monterey,California 93940 •Phone(800)511-9300 •Fax(831)394-5979 <br /> Elc <br /> Project Name � Project Manager .� �J <br /> N <br /> A r'1 G 'l.'1� � ��n I Cv'�1► 2 J �..� <br /> Client Sampler(initials&signature) <br /> Invoice to: �AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> r� I � �9 20l <br /> Z. J S' 1 o ('i ►�� ISC <br /> r�a -► � �---- j �t t I �-� <br /> f <br /> 3- S t . t• 13-} <br /> 1� z _s <br /> J0 5 Q7 <br /> 3 � S <br /> Relinquished by: Date: c� Time: Laboratory: <br /> J fiv, C �L <br /> Courier: Received by: ` Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours( <br /> ours 5 days(standard) then. Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> Global[D: / 1 <br /> Geotracker EDF to:❑ geotracker@advgeoenv.com 0 vI 1 t <br />